How The Right Birth Control Can Reduce Endometriosis Painby Julie Ryan Patient Advocate
I began taking birth control pills when I was 21 and continued taking them until my early 30s. I had to stop taking them after a blood pressure crisis landed me in the emergency room. While the crisis had nothing to do with the birth control pills, my gynecologist took me off them as a precaution. It was only after I stopped taking them that I began experiencing symptoms of what I would later find out was endometriosis, a chronic condition that can cause painful periods.
My endometriosis diagnosis
When I was in my teens, I experienced cramps during menstruation, and my periods were longer than what most of my friends experienced. But to me, nothing really seemed abnormal. My periods would last exactly seven days and the cramps were never so bad that I had to miss school.
After I stopped taking birth control, however, things had changed: The cramps were much worse than I ever remembered when I was young, and my periods would range in length from five to 10 days, with my cycle varying quite a bit as well.
I began experiencing pain during sex, but it wasn’t until I began having extreme abdominal pain at random times that I sought out an answer. One doctor referred me to another doctor and then to another before my gastroenterologist suggested that it might be endometriosis. My gynecologist later confirmed this diagnosis through laparoscopic surgery.
I later saw an endometriosis specialist who told me that progesterone, a key ingredient in birth control pills, can limit the growth of endometriosis. He suggested taking a compounded progesterone pill that wasn’t a birth control pill. While it helped some, I still had cramps and bloating during my period.
Birth control pills, round 2: Searching for endometriosis relief
Because my blood pressure had not been an issue in several years, I asked if we could try putting me back on the same pill I’d had success with for so many years in my 20s: LoEstrin Fe. My doctor agreed that it was worth a try.
I took it for about six months, but my body’s response was not the same as it had been previously. I experienced severe cramps and bloating during my period, which are symptoms of endometriosis, according to the Office on Women’s Health. And, to make matters worse, the pill seemed to affect both my mood and sex drive, causing stress in my already-stressed marriage.
I returned to my specialist in tears. He put me back on progesterone at a higher dose and my symptoms decreased significantly. My sex drive also returned and overall life improved.
Looking back, I can’t recall if he ever suggested an intrauterine device (IUD). It’s possible that he did, and I resisted it because the idea scared me. My husband eventually got a vasectomy, so birth control wasn’t really an issue anymore.
Could an IUD be the answer to endometriosis woes?
Following my divorce in 2017, I began considering birth control again primarily because compounded progesterone wasn’t covered by my insurance and I couldn’t afford the expense.
When I visited my regular gynecologist, the nurse practitioner was surprised that despite the dosage of progesterone I’d been taking for several years, I still had full periods. She suggested that I consider an IUD. According to her, it would solve all my problems.
She told me that most women eventually stop having periods with a hormonal IUD, and the progesterone it releases would keep the endometriosis in check.
I’d just had my third endometriosis surgery less than a year prior to this discussion, and I wanted to avoid a fourth, if possible. It would also act as birth control, and given that I planned to start dating again, that would become a necessity.
I opted for the Mirena IUD on the suggestion of my gynecologist, and I was quite happy when my insurance fully covered the insertion and follow-up visits, making this a completely free birth control option that would also (hopefully) reduce my monthly medication costs and control the endometriosis.
Almost a year later, I still have periods. I’m guessing I am one of those that probably always will. However, my periods are now so light that I don’t need more than panty liners. For the first six months, I spotted almost continually. Now, I just have really long periods — about 10 days, typically.
On the upside, I have no cramps or other endometriosis symptoms. I’ve also not had any change to my mood or sex drive because of the IUD.
On my last visit to the endometriosis specialist, he was amazed at how well I was doing. The tightness and tenderness he usually encountered during my exams was completely gone. I would normally see him every six months, but I now only need to see him annually.
I really wish I’d gotten an IUD earlier. Had I opted for this option after my earliest surgeries I might have avoided the most recent one, and I know I would have saved money and experienced a lot less pain. If you’re struggling with endometriosis, I encourage you to speak with your doctor about birth control options like the IUD. While birth control affects everyone differently, it could be the solution you’ve been looking for.